EDI 252 Insurance Producer Administration

Functional Group IE

X12N Insurance Subcommittee

This Draft Standard for Trial Use contains the format and establishes the data contents of the Insurance Producer Administration Transaction Set (252) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set is used to transmit insurance producer information (licensing and appointment data, background information, etc.) among insurance companies and insurance distributors such as agents, brokers, and their organizations.

Heading

1. 010 · ST · Transaction Set Header · Max 1 · Mandatory

   To indicate the start of a transaction set and to assign a control number

2. 020 · BGN · Beginning Segment · Max 1 · Mandatory

   To indicate the beginning of a transaction set

3. 030 · DTP · Date or Time or Period · Max >1 · Optional

   To specify any or all of a date, a time, or a time period

4. NM1 Loop Optional Repeat >1

   1. 040 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

      To supply the full name of an individual or organizational entity

   2. 050 · N3 · Address Information · Max 2 · Optional

      To specify the location of the named party

   3. 060 · N4 · Geographic Location · Max 1 · Optional

      To specify the geographic place of the named party

   4. 070 · REF · Reference Identification · Max 9 · Optional

      To specify identifying information

   5. 080 · PER · Administrative Communications Contact · Max 3 · Optional

      To identify a person or office to whom administrative communications should be directed

Detail

1. ENT Loop Mandatory Repeat >1

   1. 010 · ENT · Entity · Max 1 · Mandatory

      To designate the entities which are parties to a transaction and specify a reference meaningful to those entities

      The ENT loop repeats for each individual producer.

   2. 020 · ASI · Action or Status Indicator · Max 1 · Mandatory

      To indicate the action to be taken with the information provided or the status of the entity described

   3. 030 · DTP · Date or Time or Period · Max >1 · Optional

      To specify any or all of a date, a time, or a time period

   4. 040 · YNQ · Yes/No Question · Max >1 · Optional

      To identify and answer yes and no questions, including the date, time, and comments further qualifying the condition

      The YNQ segment indicates pending new business for the producer.

   5. 050 · REF · Reference Identification · Max >1 · Optional

      To specify identifying information

   6. 060 · DMG · Demographic Information · Max 1 · Optional

      To supply demographic information

   7. 070 · DMA · Additional Demographic Information · Max 1 · Optional

      To supply additional demographic identification

   8. 080 · AM1 · Informational Values · Max >1 · Optional

      To specify a code and the amount or quantity or percentage associated with it

   9. 090 · MSG · Message Text · Max >1 · Optional

      To provide a free-form format that allows the transmission of text information

   10. NM1 Loop Optional Repeat >1

       1. 100 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

          To supply the full name of an individual or organizational entity

          The NM1 loop reports all names and addresses for the producer.

       2. 110 · N2 · Additional Name Information · Max 3 · Optional

          To specify additional names or those longer than 35 characters in length

       3. 120 · EMS · Employment Position · Max 1 · Optional

          To describe employment position

       4. 130 · DTP · Date or Time or Period · Max >1 · Optional

          To specify any or all of a date, a time, or a time period

       5. N3 Loop Optional Repeat >1

          1. 140 · N3 · Address Information · Max 1 · Mandatory

             To specify the location of the named party

          2. 150 · N4 · Geographic Location · Max 1 · Optional

             To specify the geographic place of the named party

          3. 160 · COM · Communication Contact Information · Max 9 · Optional

             To specify a communication contact number

          4. 170 · DTP · Date or Time or Period · Max >1 · Optional

             To specify any or all of a date, a time, or a time period

   11. N9 Loop Optional Repeat >1

       1. 180 · N9 · Reference Identification · Max 1 · Mandatory

          To transmit identifying information as specified by the Reference Identification Qualifier

          The N9 loop is used to report transfers of business between producers.

       2. 190 · N4 · Geographic Location · Max 1 · Optional

          To specify the geographic place of the named party

       3. REF Loop Optional Repeat >1

          1. 200 · REF · Reference Identification · Max 1 · Mandatory

             To specify identifying information

          2. 210 · NM1 · Individual or Organizational Name · Max 1 · Optional

             To supply the full name of an individual or organizational entity

             The NM1 segment identifies transferred policy owners.

   12. UC Loop Optional Repeat >1

       1. 220 · UC · Underwriting Category · Max 1 · Mandatory

          To identify the category of underwriting data being transmitted

          The UC loop is used to report background information.

       2. 230 · III · Information · Max >1 · Optional

          To report information

       3. 240 · EMS · Employment Position · Max 1 · Optional

          To describe employment position

       4. 250 · NM1 · Individual or Organizational Name · Max 1 · Optional

          To supply the full name of an individual or organizational entity

          The NM1 segment identifies parties related to the background events.

       5. 260 · N3 · Address Information · Max 3 · Optional

          To specify the location of the named party

       6. 270 · N4 · Geographic Location · Max 1 · Optional

          To specify the geographic place of the named party

       7. 280 · PER · Administrative Communications Contact · Max 9 · Optional

          To identify a person or office to whom administrative communications should be directed

       8. 290 · DTP · Date or Time or Period · Max >1 · Optional

          To specify any or all of a date, a time, or a time period

       9. 300 · CDS · Case Description · Max 1 · Optional

          To identify and describe a specific court case

       10. 310 · CED · Administration of Justice Event Description · Max >1 · Optional

           To describe specific administration of justice events and actions

       11. 320 · TST · Test Score Record · Max 1 · Optional

           To provide information about national, regional, state, or local tests that a student has taken

       12. 330 · SRE · Test Scores · Max 1 · Optional

           To provide scores on tests that a student has taken

       13. 340 · MSG · Message Text · Max >1 · Optional

           To provide a free-form format that allows the transmission of text information

   13. LIC Loop Optional Repeat >1

       1. 350 · LIC · License Information · Max 1 · Mandatory

          To provide license information

          The LIC loop is used to report state license information.

       2. 360 · DTP · Date or Time or Period · Max >1 · Optional

          To specify any or all of a date, a time, or a time period

       3. LIN Loop Optional Repeat >1

          1. 370 · LIN · Item Identification · Max 1 · Mandatory

             To specify basic item identification data

          2. 380 · DTP · Date or Time or Period · Max >1 · Optional

             To specify any or all of a date, a time, or a time period

             The N1 loop reports company appointments.

   14. N1 Loop Optional Repeat >1

       1. 390 · N1 · Name · Max 1 · Mandatory

          To identify a party by type of organization, name, and code

       2. SPA Loop Optional Repeat >1

          1. 400 · SPA · Status of Product or Activity · Max 1 · Mandatory

             To indicate the details and status of a product or product activity

          2. 410 · N4 · Geographic Location · Max >1 · Optional

             To specify the geographic place of the named party

          3. 420 · DTP · Date or Time or Period · Max >1 · Optional

             To specify any or all of a date, a time, or a time period

          4. 430 · YNQ · Yes/No Question · Max 1 · Optional

             To identify and answer yes and no questions, including the date, time, and comments further qualifying the condition

             The YNQ segment indicates corporate appointments.

          5. 440 · REF · Reference Identification · Max 3 · Optional

             To specify identifying information

          6. 450 · MSG · Message Text · Max >1 · Optional

             To provide a free-form format that allows the transmission of text information

          7. LIN Loop Optional Repeat >1

             1. 460 · LIN · Item Identification · Max 1 · Mandatory

                To specify basic item identification data

             2. 470 · DTP · Date or Time or Period · Max >1 · Optional

                To specify any or all of a date, a time, or a time period

   15. PWK Loop Optional Repeat >1

       1. 480 · PWK · Paperwork · Max 1 · Mandatory

          To identify the type or transmission or both of paperwork or supporting information

          The PWK loop reports the status and locations of required documents.

       2. 490 · NM1 · Individual or Organizational Name · Max 1 · Optional

          To supply the full name of an individual or organizational entity

       3. 500 · N4 · Geographic Location · Max 1 · Optional

          To specify the geographic place of the named party

       4. 510 · DTP · Date or Time or Period · Max >1 · Optional

          To specify any or all of a date, a time, or a time period

       5. EFI Loop Optional Repeat >1

          1. 520 · EFI · Electronic Format Identification · Max 1 · Mandatory

             To provide basic information about the electronic format of the interchange data

             The EFI loop is used to transmit images of required forms and signatures.

          2. 530 · BIN · Binary Data · Max 1 · Mandatory

             To transfer binary data in a single data segment and allow identification of the end of the data segment through a count; there is no identification of the internal structure of the binary data in this segment

2. 540 · SE · Transaction Set Trailer · Max 1 · Mandatory

   To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)